Lipodystrophy, Insulin injection practice, Health Related Quality of Life and associated factors among Diabetic Patients at Three Tertiary Hospitals of Northwest Ethiopia

Abstract

Introduction: Insulin injection-induced lipodystrophy alters insulin absorption, potentially leading to unpredictable hypoglycemia and inadequate glycemic control. This could adversely affect patients' health-related quality of life (HRQoL), yet there is a scarcity of studies examining the magnitudes of lipodystrophy and the level of health-related quality of life among insulin user diabetes mellitus patients. Objective: This study aimed to assess lipodystrophy, insulin injection practice, level of healthrelated quality of life, and associated factors among insulin injection user diabetic patients in northwestern Ethiopia Method: A cross-sectional study was conducted from April 5 to September 30 2023 at the University of Gondar, Tibebe ghion, and Debre Markos Comprehensive Specialized Hospitals. Data was analyzed using IBM SPSS version 25.0. Descriptive statistics, student T-test, chi-square, multivariate logistics, and multiple linear regressions were used to analyze the data. Results: Insulin-induced lipodystrophy was observed in 225 cases (53.1%). Failure to rotate [Adjusted Odds Ratio(AOR) =1.8, 95% CI (1.02-3.19), P 0.004], needle reuse [Adjusted Odds Ratio (AOR) = 3.06, 95% CI (2.002-4.25), P = 0.001], glycemic control [Adjusted Odds Ratio(AOR) =2.15 & 95% CI (1.13-4.1) p=0.019] and insulin dosage per kg [Adjusted Odds Ratio(AOR)= 2.1 & 95% CI (1.19-3.69) p=0.001] were found to have an association with lipodystrophy. In the health-related quality of life measuring dimensions, nearly half (45.8%) of research participants said they had moderate, severe, or extreme problems. And age [Adjusted Odds Ratio(AOR) = -0.46 & 95% CI (-0.497-(-0.423)] p=0.001, diabetic duration [Adjusted Odds Ratio AOR)= -0.761 & 95% CI (-0.876-(-0.645)) p=0.001], comorbidities [Adjusted Odds Ratio(AOR)= 1.165 & 95% CI (0.385- 1.946) p= 0.004], complications [Adjusted Odds Ratio(AOR)=1.068 & 95% CI (0.239-1.8980) P=0.012], and unexplained hypoglycemia [Adjusted Odds Ratio(AOR)= 2.69 & 95% CI (1.869-3.511) p-value <0.001] were found to have an association with poor HRQoL. Conclusion: The prevalence of lipodystrophy among diabetic populations using insulin injections was found to be very high, and the health-related quality of life of patients on insulin therapy was found to be poor in the study settings.